RESUMO
PURPOSE: To describe the clinical characteristics of the vitreomacular traction syndrome with macular detachment and to report our surgical experience with this condition. METHODS: A retrospective chart and photographic review was performed on nine patients (nine eyes) who had a symptomatic decrease in visual acuity from a macular traction retinal detachment caused by vitreomacular traction syndrome. Vitrectomy was performed in each eye to reattach the retina. RESULTS: Intraoperative observation confirmed partial posterior vitreous separation with adherence of the posterior hyaloid to the detached retina and separation of the posterior hyaloid from the attached retina. After surgery the macula was reattached in seven eyes (78%). Visual acuity was improved in four eyes, stable in four eyes, and worse in one eye. CONCLUSION: Macular detachment may occur secondary to vitreomacular traction syndrome. Although the retina may be reattached surgically in these cases, visual improvement may be limited by chronic detachment, premacular fibrosis, cystoid macular edema, or macular schisis.
Assuntos
Macula Lutea , Descolamento Retiniano/cirurgia , Doenças Retinianas/cirurgia , Vitrectomia , Corpo Vítreo/cirurgia , Idoso , Idoso de 80 Anos ou mais , Oftalmopatias/complicações , Oftalmopatias/patologia , Oftalmopatias/cirurgia , Feminino , Fundo de Olho , Humanos , Masculino , Descolamento Retiniano/etiologia , Descolamento Retiniano/patologia , Doenças Retinianas/complicações , Doenças Retinianas/patologia , Estudos Retrospectivos , Síndrome , Resultado do Tratamento , Acuidade Visual , Corpo Vítreo/patologiaRESUMO
The authors successfully performed clinical transpupillary retinal photocoagulation in 30 eyes of 26 patients with retinal vascular disease using a gallium-aluminium-arsenide (GaAlAs) diode laser emitting at 805 nm. Retinal photocoagulation was performed at treatment powers of 300 to 1300 mW and exposure durations of 0.2 to 0.5 seconds with a 200-microns diameter treatment spot. Patients treated with both diode and argon green lasers required 4.5 +/- 1.8 times greater mean laser energy with diode compared with argon to create ophthalmoscopically similar lesions. Parallel experimental retinal photocoagulation in Chinchilla rabbits required 3.1 +/- 0.9 times more power to create ophthalmoscopically similar lesions with the diode laser than with the argon laser. Intraoperative subretinal hemorrhage occurred rarely in patients with an incidence of 4 (0.44%) of 9021 treatment spots. Patients complained of moderate-to-marked pain in 10 (43%) of 23 treatments initiated under topical anesthesia. A transpupillary diode laser may be used clinically to perform therapeutic retinal photocoagulation.
